The discovery of the bacterium behind 5% of all cancer (H. pylori) — Barry Marshall

Описание: One bacterium causes roughly 1 in 20 cancer cases worldwide. It’s the most cancer-causing pathogen we’ve found—and the main cause of peptic ulcers. Its discovery overturned an ironclad medical dogma that the stomach was sterile.

Despite infecting about half of humanity, Helicobacter pylori wasn't discovered until 1979 and shown to cause gastritis and peptic ulcer disease in the early 1980s. Why did it evade detection for so long—and what finally broke through the consensus?

I went to Perth, Australia—where H. pylori was first discovered—to chat with Barry Marshall, gastroenterologist and co-recipient (with Robin Warren) of the 2005 Nobel Prize in Physiology or Medicine for discovering H. pylori and proving that it causes gastritis and peptic ulcer disease. Marshall famously infected himself with the bacterium to demonstrate causality and later helped develop clinical diagnostics like the urea breath test, which we demo live in the episode.

SPONSORS
This episode is sponsored by Eucalyptus, the Aussie startup providing digital healthcare clinics to help patients around the world take control of their quality of life. Euc is looking to hire ambitious young Aussies and Brits. You can check out their open roles at https://www.eucalyptus.health/careers.

This episode is also sponsored by Vanta, which helps businesses automate security and compliance needs. For a limited time, get one thousand dollars off Vanta at https://www.vanta.com/joe.

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TIMESTAMPS
(00:00:00) - Introduction.
(00:01:53) - Was H. pylori behind Darwin's dyspepsia and Napoleon's cancer?
(00:09:57) - Which cancer has killed the most in history?
(00:12:18) - Why stomach cancer fell in the West.
(00:15:05) - Why are duodenal ulcers and stomach cancer mutually exclusive? Both are caused by H. pylori.
(00:26:15) - Quick gastrointestinal anatomy lesson.
(00:30:15) - The "H. pylori enigmas" (Africa, India, Costa Rica, etc).
(00:35:15) - Is there a "point of no return" in the cascade from H. pylori infection to stomach cancer?
(00:43:11) - Joe does a urea breath test live on the pod!
(01:08:40) - What Barry learned about manufacturing by trying to make millions of H. pylori tests in Perth.
(01:16:50) - Four clues to the existence of H. pylori. (If you'd known these, you could have discovered it without even laying eyes on it.)
(01:25:58) - How MEDLINE/the internet enabled the discovery.
(01:31:45) - Why wasn't H. pylori discovered earlier than 1979?
(01:37:45) - How fiberoptic endoscopes enabled the discovery.
(01:38:44) - The 1954 Palmer null result and its fallout.
(01:43:08) - Scientific knowledge diffuses more slowly than you'd expect (H. pylori as a case study).
(01:44:49) - If H. pylori was discovered in 2015, would mainstream acceptance still have taken 10 years?
(01:47:40) - Self-experimentation in science.
(01:55:40) - Barry reflects on his partnership with Robin Warren (with whom he shared the Nobel).
(02:07:09) - Benefits of H. pylori?
(02:09:45) - Eradication prospects & vaccine timeline.
(02:14:29) - Blurring infectious vs chronic disease.